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veg in hand

Heart Disease is Preventable and Reversible through Nutritional Intervention

Heart disease is devastating to both our health and our economy. It is the number one cause of death in the country. Cardiovascular disease (CVD) accounted for 32.1 percent of deaths in the United States in 2013 – one out of every three deaths is due to this preventable disease.1 A significant number of research studies have documented that heart disease is easily and almost completely preventable (and reversible) through a diet rich in plant produce and lower in processed foods and animal products.6-9

As the prevalence of CVD escalates, medical costs are rising rapidly. The American Heart Association has projected that by 2030, 40.5 percent of the US population will have some form of cardiovascular disease, and the direct medical costs attributed to cardiovascular diseases will triple compared to 2010 costs.2

Risk factors for heart disease are commonplace for U.S. adults:32.6 percent have hypertension, 13.1 percent have total cholesterol above 240 mg/dl,3 9.3 percent of U.S. adults have diabetes,4 and 68.5 percent of U.S. adults are overweight or obese.5 As a result, it has become considered normal in our society to have atherosclerosis, and to die from cardiovascular disease. If you eat the standard western diet that most people eat in the modern world, you will surely develop heart disease and may die from it.

Fighting heart disease: Superior nutrition versus drugs and surgery

In 2015, I published a scientific article in the American Journal of Lifestyle Medicine demonstrating, with survey data and case histories, the dramatic weight loss and cardiovascular benefits possible with a Nutritarian diet. Respondents who started out obese lost an average of over 50 pounds two years after the switch to a Nutritarian diet. After one year, in those who started out with hypertension, there was a 26 mm Hg average reduction in systolic blood pressure. In respondents who were not taking cholesterol-lowering medication, there was an average 42 mg/dl decrease in LDL cholesterol, and an average decrease in triglycerides of 79.5 mg/dl.10

The surgical interventions commonly used to treat heart disease, such as angioplasty and bypass surgery are futile. The COURAGE trial and additional studies conducted since have documented that patients undergoing those invasive procedures do not live longer or have fewer heart attacks compared to those receiving medical therapy  with modest lifestyle changes.11-12 Surgical interventions are not long-term solutions to heart disease; they merely treat a small portion of a blood vessel, while cardiovascular disease continues to progress throughout the vasculature.

Drugs that treat hypertension and elevated cholesterol carry serious risks and do not stop heart disease from progressing. Cholesterol-lowering statin drugs are known to increase the risk of diabetes, impaired muscle function, cataracts, liver dysfunction and kidney injury. 13 Each different class of blood pressure-lowering medications is associated with its own risks and side effects. ACE inhibitors commonly cause a persistent cough; diuretics are linked to increased risk of diabetes; beta blockers are associated with increased likelihood of stroke; calcium channel blockers may increase risk of heart attack and breast cancer; and ARBs are associated with increased risk of lung cancer.14-20

The risk associated with these treatments is unacceptable when there is a safe, effective alternative —smart nutrition and exercise – that can actually reverse heart disease and obliterate the need for risky and even futile medical care. Atherosclerotic plaque can be reversed, and cholesterol lowered without drugs or surgery.

Success stories (two of numerous)

Ronnie weighed over 300 pounds when he wound up needing emergency quadruple bypass surgery.  Three years later, he was back for an angioplasty and three stents, but his chest pain returned within one month of the surgery. Working with Dr. Fuhrman in the Ask the Doctor Community, Ronnie lost 140 pounds and went off all medications. He runs and plays sports and has served as an inspiration to family members who have also lost weight and begun to live healthier lives. Read his story.

Julia had three heart attacks within three months. After her fifth angioplasty, she still had constant chest pain. She was on 10 different daily medications, suffered migraines, and, at the age of 60, could not walk even one block. Today, Julia has lost 105 pounds, and now enjoys every day pleasures like exercise, gardening, and playing with her grandchildren. She went from a “cardiac cripple” to a healthy, happy woman. Read her story.

Like Ronnie and Julia, over the last 20 years hundreds of my other patients with advanced heart disease have demonstrated that dramatic reversal of advanced disease can even occur in a relatively short time.

Following the lenient recommendations of the American Heart Association and wearing a red dress pin do not form an effective strategy for protecting you or your loved ones against heart disease. Also, drugs and surgery do not cure heart disease. A health-promoting, nutrient-dense (Nutritarian) diet, that I have designed and advanced over the years (coupled with exercise) is dramatically effective and protective for preventing and reversing  high blood pressure, high cholesterol and diabetes — as well as heart disease — because it removes the primary dietary cause of heart disease, while providing the most protective and life-span promoting diet-style. For more information, check out my book, The End of Heart Disease.

Everyone needs to know that heart disease can be avoided; and those who already have heart disease deserve to know that they can reverse their disease. Conventional medical care does NOT protect against heart disease-related death. Only a Nutritarian diet can offer dramatic lifespan-enhancing benefits against both cardiovascular disease and cancer.

Originally printed on DrFuhrman.com. Reprinted with permission.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient-dense, plant-rich eating style.

References

  1.  Xu J, Murphy SL, Kochanek KD, et al: Deaths: Final Data for 2013. Natl Vital Stat Rep 2016;64:1-119.
  2. Heidenreich PA, Trogdon JG, Khavjou OA, et al: Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement From the American Heart Association. Circulation 2011.
  3. Mozaffarian D, Benjamin EJ, Go AS, et al: Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016;133:e38-e360.
  4. American Diabetes Association: Diabetes statistics [http://www.diabetes.org/diabetes-basics/statistics/]
  5. Ogden CL, Carroll MD, Kit BK, et al: Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311:806-814.
  6. Ornish D, Brown SE, Scherwitz LW, et al: Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-133.
  7. Ornish D, Scherwitz LW, Billings JH, et al: Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998;280:2001-2007.
  8. Esselstyn CB, Jr.: Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). Am J Cardiol 1999;84:339-341, A338.
  9. Esselstyn CB, Jr., Ellis SG, Medendorp SV, et al: A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice. J Fam Pract 1995;41:560-568.
  10. Fuhrman J, Singer M: Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
  11. Boden WE, O’Rourke RA, Teo KK, et al: Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356:1503-1516.
  12. Trikalinos TA, Alsheikh-Ali AA, Tatsioni A, et al: Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet 2009;373:911-918.
  13. Hippisley-Cox J, Coupland C: Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010;340:c2197.
  14. Simon SR, Black HR, Moser M, et al: Cough and ACE inhibitors. Arch Intern Med 1992;152:1698-1700.
  15. Bangalore S, Messerli FH, Kostis JB, et al: Cardiovascular protection using beta-blockers: a critical review of the evidence. J Am Coll Cardiol 2007;50:563-572.
  16. Gupta AK, Dahlof B, Dobson J, et al: Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm and the relative influence of antihypertensive medication. Diabetes Care 2008;31:982-988.
  17. Wassertheil-Smoller S, Psaty B, Greenland P, et al: Association between cardiovascular outcomes and antihypertensive drug treatment in older women. JAMA 2004;292:2849-2859.
  18. Group PS, Devereaux PJ, Yang H, et al: Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008;371:1839-1847.
  19. Li CI, Daling JR, Tang MT, et al: Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years. JAMA Intern Med 2013.
  20. Sipahi I, Debanne SM, Rowland DY, et al: Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials. Lancet Oncol 2010;11:627-636.
trainer-with-senior-woman-at-treadmill

How the Human Body Changes As It Ages

The human body undergoes a lot of changes during its lifetime. From infancy to old age, there are biochemical processes in the body that define these changes.

Some of them are visible externally, such as the greying of hair, skin becoming less supple, etc.

But beneath all of this, some processes happen to make all of this possible.

woman lifting crossfit-534615_1280

Why Women Should Lift

Just a generation ago, women’s weight-lifting was largely isolated to professional athletes and competitive body-builders. Men have been lifting weights for years, but it has not come into the mainstream for women until the past 10-15 years. 

Some of the barriers to the barbell for women may include fear of injury, lack of accessibility to an environment where they can learn and lift weights safely, and even more compelling are concerns about body image: “I don’t want to get too bulky”. Today, we know so much more about the overall health and athletic performance benefits of weight training. As more women have flooded competitive and professional sports and with the emergence of CrossFit and other resistance based group fitness classes, weight training has become commonplace in women’s organized sports and recreational fitness programs. But still today, the barriers to the barbell still exist with many misconceptions about risk of injury and body image concerns. 

The Effect of Aging on our Muscles and Joints

Being a well-rounded athlete includes not only endurance, flexibility and agility, but also muscular strength.  Our muscles move our skeleton, protect our joints, are a major source of energy expenditure and play an important role in blood sugar management. Like our heart and lungs, our skeletal muscles need exercise to stay healthy so they can continue to carry out these functions for our entire lives. Over time, especially into the menopausal years, women begin to lose muscle mass and bone density. Decline in estrogen levels increases the rate of bone loss and joint laxity leaving us more vulnerable to injury and fractures. With the loss of muscle mass, our metabolism slows and activities may become limited. But it doesn’t have to be this way. One important weapon to combat these natural changes is the all-mighty barbell! 

Health Benefits of Weight Training

As young women, weight training helps performance across a spectrum of recreational and professional sports and builds a solid foundation of lean body mass, strength and functionality for the future. Starting from puberty, bone density increases until it peaks in our early 30’s.  Weight-bearing exercise, along with sound nutrition, optimizes bone density development to prevent osteoporosis and fractures later in life. Into our 40’s, 50’s and beyond, weight training and attention to nutrition and recovery can not only slow the loss of bone density and muscle mass that comes with menopause, but may even result in continued improvement– especially if weight training was not started until later in life. Increasing and maintaining muscle mass in this age group also affords stability to joints such as shoulders, knees and hips thus preventing injury. But what if I’m already in my 60’s and beyond and I have never lifted weights before? Is it too late to start? Absolutely not! At age 89, my mother started doing deadlifts and chair squats with gallon milk jugs. Weight training for beginners can start with weighted household items, progress to dumbbells and to group classes such as Boot Camps, Crossfit and other similar type classes. In all age groups, like with any new sport or activity, beginners should focus on strict technique and mechanics with an experienced coach or instructor before increasing load and intensity.

A Word about Body Image

When I started weight training in the mid-1980’s, skinny was in. I was always self-conscious about doing too much leg work because my legs became very muscular. So I stopped training my legs – for literally decades. And now I am paying the price. But through Crossfit I have regained a lot of what I could have developed in my younger years. Today, I very much regret surrendering to the societal ideal at the time. Because “society” doesn’t have to contend with my personal struggle to start rebuilding leg strength after age 45. Fortunately, today is different, “Strong is the new sexy”. But the body-shamers and the haters still exist and feel compelled to impose their beliefs and ideals on others. But the truth is that your strongest, healthiest, most confident self is your most beautiful self – not some societal ideal. So whether you are 18 or 80, grab those weights and give your body the gift of strength that will keep you healthy, active and living life to the fullest for years to come.

Join Dr. DiGirolamo for her webinar, Hormones and You: Knowledge is Power


Dr. Carla DiGirolamo is a double Board-Certified Obstetrician/Gynecologist and Reproductive Endocrinologist who specializes in the care of reproductive age and mid-life women. Carla completed her residency training in Obstetrics and Gynecology at Brown University Medical School/Women and Infants’ Hospital and her Reproductive Endocrinology training at the Massachusetts General Hospital at Harvard Medical School. She is a North American Menopause Society (NAMS) Certified Menopause Practitioner and has been featured in multiple podcasts and speakerships at various events discussing the physiology of the hormonal changes of menopause, hormone therapy and functional fitness training.

woman heating pad

Why Suffer in Silence?

In America today, 40% of females, including women, children and teens, suffer in silence with either primary or secondary dysmenorrhea every month. Primary dysmenorrhea accompanies the monthly menstrual cycle without any underlying medical conditions. Secondary dysmenorrhea means that there is another medical issue present, such as endometriosis. This condition makes it hard to function, with most women being bedridden for three to five days or longer. Dysmenorrhea is not a weakness, but a real medical issue.

Generally, the female client will have severe throbbing pain from the waist down. They can feel it in their stomach, low back, legs and feet, making it hard to move. Other symptoms include nausea, vomiting, diarrhea, anxiety, stress, depression, lightheadedness, fatigue, headache, fever, and depression, weakness and fainting. Risk factors are smoking, obesity, being underweight, strong family history, high levels of stress, anxiety and/or depression. Women can still have painful stomach cramping well after menopause if they have Endometriosis.

This is a silent stressor for many women because they rarely choose to speak about it. Some have been living with the pain for twenty years or more and think there is nothing they can do. If a client comes to you and mentions that they have a lot of pain, urge them to see their doctor. This conversation is more likely to happen with a female personal trainer. The good news is that fitness professionals can help their clients to feel better during this painful time of the month.

It is important to acknowledge this painful condition because of the physical and mental implications that come along with it. As the trainer you, may be working with a therapist as well as an OB/GYN. You are trying to help your client feel better overall. We recommend scheduling an assessment first to understand the client’s medical history. As a fitness professional, you may want to refer your clients to other professionals as well. Acupuncture, for example, is well known for helping women to ease and reduce anxiety. When you network with other professionals, you form a referral system to obtain more clients for yourself, too.

After completing your assessment, you will develop a wellness program for your client. The program will include: exercise, meditation (specific to this condition), and aromatherapy, as well as other components. Try to have your client establish a regular daily wellness routine. Journaling is also important as it helps to connect your thoughts, feelings and behaviors. Support groups can also help as women share their experiences with others.


Robyn Kade is the President/CEO of The Stress Management Institute for Health and Fitness Professionals™ and the SMI Business Institute™. Robyn received her Bachelor’s Degree from Rowan University in Health Promotion and Fitness Management. She is an American Council on Exercise (ACE) personal trainer and group fitness instructor, received a certificate in PTSD through the Kew Training Academy, and is a Compassion Fatigue Resiliency and Recovery – Educator. Robyn is also certified through the American College of Sports Medicine for Exercise Is Medicine (EIM) Level 1. Robyn is currently pursuing her Master’s Degree in Wellness and Lifestyle Management with a concentration on Wellness Coaching at Rowan University.


References

gavel

Exercise Prescription and the Standard of Care

To minimize injuries and subsequent negligence claims/lawsuits, exercise professionals need to be aware of their many legal duties and risk management responsibilities. When faced with a negligence lawsuit, courts will determine the standard of care (or duty) of an exercise professional. If the court finds that the exercise professional breached a duty and the breach of duty caused harm to the plaintiff (injured party), the exercise professional (and the professional’s employer) may be found negligent and, thus, liable for the plaintiff’s harm and will need to pay monetary damages. The damages can be in the millions of dollars. For example, the jury awarded the plaintiff $14,500,000 in Vaid v. Equinox (1).

Factors Courts Consider When Determining the Standard of Care

Legal scholar, the late Betty van der Smissen, stated: “if one accepts responsibility for giving leadership to an activity or providing a service, one’s performance is measured against the standard of care of a qualified professional for that situation” (2, p. 40).

A “qualified” professional possesses proper credentials and is competent. A competent exercise professional knows how (has the knowledge and practical skills) to design and deliver a “safe” and “effective” exercise program.

As described by van der Smissen,“for that situation” is determined by reference to the following three factors:

  • The Nature of the Activity
  • The Type of Participants
  • The Environmental Conditions

Nature of the activity

The professional must be aware of the skills and abilities the participant needs to participate “safely” in the activity, e.g., the exercise professional must possess adequate knowledge and skills to lead “reasonably safe” exercise programs.

Example: Exercise professionals that lead exercise programs that are considered “advanced” that can increase the risk of injury (e.g., Olympic lifting, high intensity programs) need to have advanced knowledge and skills necessary to safely lead these types of programs, i.e., they need to be fully informed of precautions that must be taken.

Type of participants

The professional must be aware of individual factors of the participant, e.g., medical conditions that impose increased risks and know how to minimize those risks.

Example:  Exercise professionals that design/deliver exercise programs for individuals with medical conditions (e.g., pregnancy, diabetes, back problems) need to possess credentials and competence in clinical exercise by completing clinical academic coursework/education as well as obtaining clinical certifications and experience (3). From a legal liability perspective, it is essential that exercise professionals fully understand any additional or unique risks the medical conditions(s) might impose and how to minimize those risks.  In Bartlett v. Push to Walk (4), the court stated:

Programs like Push to Walk “May impose particular duties that an ordinary health club would not have…What would constitute…negligence would differ    between an ordinary health club and a facility like Push to Walk” (p. 7).

Environmental conditions

The professional must be aware of any conditions that may increase risks, e.g., weather conditions such as heat/humidity, floor surfaces, exercise equipment, and know how to minimize those risks.

Example: Exercise professionals need to have the necessary knowledge and skills to properly implement important safety precautions to help prevent heat injuries. Knowing and implementing precautions to minimize risks associated with slippery floor surfaces and improper maintenance of equipment is also important.

Case Example: Levy v. Town Sports International, Inc. (5)  

A personal trainer had a client, Levy with known osteoporosis, perform a series of jump repetitions on a BOSU ball. After a few reps, she lost her balance and fell fracturing her wrist that required surgery to have a plate and screws inserted into her wrist. She filed a negligence lawsuit against the defendant facility.* The facility filed a motion for summary judgment (request to dismiss the case). Trial court granted the defendant’s motion, and the plaintiff appealed. Upon the appeal, the appellate court reversed the trial court’s ruling. The court stated that the trainer, knowing Levy had osteoporosis, unreasonably increased the risk of harm to her by having her perform an advanced exercise. The appellate court considered the nature of the activity (jumping repetitions on a BOSU ball) and the type of participant (client with osteoporosis) and determined that the exercise professional did not meet the standard of care for that situation.

*In a negligence lawsuit, in addition to the exercise professional, the fitness facility is also named as a defendant through a legal principle called respondeat superior, in which the employer can be vicariously liable for the negligent acts of its employees.

Conclusion

Meeting the standard of care when prescribing exercise for individuals with medical conditions begins by exercise professionals obtaining the necessary credentials and competence. It was obvious that the trainer in the Levy case did not have the necessary knowledge and skills to prescribe a safe and effective program for a client with osteoporosis. The trainer failed to take important precautions to minimize the risk of a fall.

Join Joann for her webinar on this topic, Exercise Prescriptions: Linking Safety and Business Success


Information provided in this article comes from: Law For Fitness Managers and Exercise — the only comprehensive resource for fitness managers and exercise professional who want to: PROTECT THEMESELVES, THEIR BUSINESS, AND THEIR CLIENTS! For education programs that accompany the text, go to: Educational Courses (fitnesslawacademy.com)

JoAnn M. Eickhoff-Shemek, Ph.D., FACSM, FAWHP, professor emeritus, Exercise Science at the University of South Florida and president of the Fitness Law Academy, LLC, is an internationally known author and speaker. For more than 35 years, her teaching and research have focused on fitness safety, legal liability, and risk management issues. Dr. Eickhoff-Shemek is the lead author of a comprehensive legal/risk management text, Law for Fitness Managers and Exercise Professionals, and is the co-author of another textbook, Rule the Rule of Workplace Wellness Programs, published in 2020 and 2021, respectively.

References

  1. Vaid v. Equinox, CV136019426, 2016 LEXIS 828 (Conn. Super. Ct., 2016).
  2. Van der Smissen van der Smissen B. Elements of Negligence. In: Cotten DJ, Wolohan JT, eds. Law for Recreation and Sport Managers, 4th Ed. Dubuque, IA: Kendall/Hunt Publishing Company,
  3. Warburton DER, Bredin SSD, Charlesworth SA, et al. Evidence-Based Risk Recommendations for Best Practices in the Training of Qualified Exercise Professionals Working with Clinical Populations. Applied Physiology Nutrition and Metabolism 36, S232-S265, 2011.
  4. Bartlett v. Push to Walk, 2018 WL 1726262 (2018 U.S. Dist. Ct., D. N.J.).
  5. Levy v. Town Sports International, Inc., 101 A.D.3d 519 (2012 N.Y. App. Div. LEXIS 8543).
scale

Once You Lose Weight, Can You Keep It Off?

“I lost 10 pounds and vowed to keep them off, but no such luck. I’m so discouraged.”

“I reached my goal weight, then BOOM, I regained it once I stopped dieting.

“This is my 3rd time losing 40 pounds…”

If any of those stories sound familiar, you are not alone. Research suggests dieters tend to regain lost weight within five years, if not sooner. This includes many fitness exercisers and athletes who struggle to stay at a goal weight.

If you are fearful of regaining your hard-lost weight, this article will help you understand why maintaining lost weight takes effort. Paul MacLean, PhD, Professor of Medicine & Pathology at the University of Colorado School of Medicine, has carefully studied weight regain. He notes three reasons why dieters regain weight: biology, behavior, and environment.

Biology: The body has a strong biological drive to regain lost weight, as noted with increased appetite and a slowed metabolic rate. As backlash from dieting, the body learns to store fuel very efficiently as fat.

Behavior: After three to nine months, dieters tend to be less strict with their low-calorie diets; they often report they have hit a weight plateau. Despite self-reported claims they are diligently dieting (yet only maintaining weight), these dieters can become discouraged and less adherent. (Note: Diligently dieting anecdotes are hard to verify.)

Environment: We live in an obesogenic environment with easy access to ultra-processed foods, a sedentary lifestyle, and chemicals that contribute to weight gain including those found in upholstered furniture, pesticides, cosmetics, and who knows where else. Weight is far more complex than self-induced over-eating and under-exercising!

When adding on exercise, some people lose weight and some gain weight. Exercise alone does not guarantee fat loss. Exercisers who lose weight tend to keep the weight off if they stick with their exercise program. High levels of exercise are linked with greater success. That’s good news for athletes who train regularly! That said, a fine line exists between compulsive exercisers (who exercise to burn off calories) and athletes (who train to improve their performance). Fear of weight gain can impact both groups.

Questions arise:

  1. Is weight maintenance more about being compliant to a restrictive eating plan than to exercise?
  2. Do those who comply with a strict diet escape weight-regain?
  3. Are exercisers more likely to stay on their diet?
  4. Does exercise create metabolic adaptations that favor maintaining lost weight?

Research with rodents

Finding answers to these questions is hard to do in humans because of biology, behaviors, and environment. So MacLean turned to studying formerly obese rodents who had lost weight by being put “on a diet” and then were allowed to eat as desired for 8 weeks. Some weight-reduced rodents stayed sedentary while others got exercised.

  • Fancy cages accurately measured the rodents’ energy intake and energy expenditure. MacLean was able to see how many calories the rodents burned and if they preferentially burned carbohydrate, protein, or fat for fuel.
  • The exercise reduced-obese rodents ate less than the sedentary rodents and they regained less weight. Exercise seemed to curb their drive to overeat, meaning they felt less biological pressure to go off the diet. With exercise, their appetites more closely matched their energy needs.
  • Exercise promoted the burning of dietary fat for fuel. Hence, the exercised rodents converted less dietary fat into body fat. They used carbohydrate to replenish depleted glycogen stores. Note: Carbohydrate inefficiently converts into body fat. That is, converting carb (and also protein) into body fat uses ~25% of ingested calories to pay for that energy deposition. To convert dietary fat into body fat requires only ~2% of ingested calories. Given the calorie-burn of exercise plus the metabolic cost of converting carbs into body fat, the exercised rodents regained less weight.
  • The sedentary rodents ate heartily and were content to be inactive. Their bodies efficiently converted dietary fat into body fat; they used carb & protein to support their limited energy needs. They easily regained weight.

The Depressing News

When followed over time, the longer the rodents were weight-reduced, the stronger their appetites and drive to eat got. When allowed to eat as desired, they quickly regained the weight. “At least people, as compared to rodents, can be taught to change their eating behaviors to help counter those biological pressures,” noted MacLean. For example, people who have lost weight can stop buying fried foods, store snacks out of sight, limit restaurant eating, etc.

More depressing news. Most of MacLean’s data is from reduced-obese male rodents. Exercised males showed less weight regain than did exercised females. The female rodents seemed to know they needed extra energy to exercise, so they ate more and regained weight. MacLean states we need more research to understand the clear differences in the biological drive to regain weight.

A glimmer of hope

The best way to maintain weight is to not gain it in the first place. Yes, easier said than done (as stated upfront), but at least athletic people who maintain a consistent exercise program can curb weight regain. We can also change our behaviors to minimize weight regain by prioritizing sleep, curbing mindless eating, and choosing minimally processed foods.

Ideally, the sports culture will change so that athletes can focus less on weight and more on performance. It’s time to acknowledge that athletes, like dogs, come in many sizes and shapes. Some athletes are like St. Bernards, others are like Greyhounds. A starved St. Bernard does not become a Greyhound, but rather a miserable St. Bernard.

By fueling your genetic body type and focusing on how well you can perform, you can enjoy being stronger, more powerful—and likely can still meet your sports goals. When being leaner comes with a life-long sentence to Food & Exercise Jail, you might want to think again?


Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more info.

Walking-Sneakers

A Clearer Vision in Training

As fitness professionals, what we can expect is the unexpected. Often the last person we think may send an inquiry, does. If you’re like me and the majority of your training is in-home, you often get the privilege to work with so many you may not otherwise in a traditional gym or studio setting.

The Unexpected Client

While I was used to receiving various inquiries from those with different chronic conditions or disease, disabilities and other limiting factors, the one I didn’t anticipate was a blind client. The first thing I did before responding was see what trainers in my area may be willing to work with this individual, no response, no one was interested. My first thought was my “scope of practice”. Surely this wasn’t in that category for me. While I took time to reflect on how I could possibly help this person, I did some asking around to a well-respected fitness professional not in my area. I asked him, “How do you train a blind person?” He responded by saying, “I have never had the chance to do that but I would say you train him just like anyone else.” That made complete sense to me in that moment. What I didn’t know I would research. Next, I would fully disclose that I did not have prior experience with training a blind person, but I would be happy to take him on. So, I did.

Learning Curve

In researching training the blind community and speaking with a few people in various agencies, I couldn’t get much beyond the science and statistics. No methods, no accommodations, no modifications, no advice, not much to guide me. I did learn about Orientation and Mobility Specialists and while that was needed in the beginning for my client, it was not needed for him to have at the time for the training to take place.

You adjust everything you know about training. A huge eye opener for me was learning that I had a vision dependency on cueing. My verbal cueing was subpar. Too often I was used to saying, “Watch me first, then you try,” then correcting form as needed. In programming for my client, I needed to better learn to be descriptive so that what he could not see, he could imagine in the mind. It had to make sense.

Tips

What helped me to make progress, not just with my blind client but in general, was to really read the descriptions of exercise, movement and anatomy. Even if I had to read it continuously to better explain, that is what I did. When something didn’t make sense, we just eliminated it and found a better option.

Learning to count steps was another big deal. It was critical to know how to express inches, feet, yards when walking or moving around. For example, we are 2 yards from your driveway, in 2 feet there is a table, it is 35 steps to your mailbox.

Blindfold yourself. Close your eyes when exercising. Have another trainer, family member or friend, tell you some of the exercises that you find hard to describe and learn from those examples. Get a real feel for what your client may experience. Learn how they use their cane and the types of canes (sticks). One wealth of information came to me from a blind athlete. He took time to talk to me and just reinforce how important it is for my client to be independent.

Announce what you’re doing before you do it. It’s the same with asking to touch a client, “Is it okay if I touch your elbow?” Or, “I am going to pick up these dumbbells.”

Challenges

Learning to not be so protective, smothering and motherly, as was my nature as a mother of five. I was scared every moment, what if my client falls, trips, bumps into the wall, anything. I felt I had to always be on guard and with the slightest change in movement or awkward movement, I would have my arm ready to catch if I needed. Too much! It was very helpful that a few times I had another trainer in training (my husband) come along with me and he brought it to my attention. I told him, I know I can do it, but what if something happens? He said, it just will and I can’t spend every minute in protection mode. It’s not good for me or the independence of my client.

Programming always changed. There were days we just walked because that was as much as my client could handle. Cancellations due to various reasons required me to step up and not be taken advantage of as well. Adapting to all of that and being patient in what my client needed took time.

Addictions (substance abuse). While I won’t get into much depth on this topic, there were many other challenges within this area that I was exposed to and needed to refer out and gain help for. Again, it was the unexpected.

Nutrition problems. Making sure my client was eating, what and when. There were many discussions we had regarding proper nutrition. Much of it would lead back to other barriers, such a cigarettes or substance abuse. It required other professional intervention, as I am not a Registered Dietitian, but we did review general eating habits and good vs bad. Occasionally, we got it just right.

Dawn working with her client

The Workouts

While the primary goal was weight loss and increased strength for my client, we tackled everything. We incorporated cardiovascular activities and ones we did often were running together with a rope (tether), jumping jacks, and walking. But every part of the programming goals were to incorporate functional exercises which all required flexibility, balance, core, resistance, strength training, and what my client could focus on doing alone. We used dumbbells, resistance bands, sandbells, medicine balls, jump ropes, tires, picnic table, stairs, Airex pad and simply bodyweight. The most important use of all the exercise was in how it would further benefit my client and the goals we set. Nothing should be useless training.

In closing

While there is so much more to be said on how I trained my blind client, the most important message to relay is to not be afraid of what you can’t do, but do what you can. We should always ask questions, always expand our knowledge and do what we as fitness professionals are here for — to assist in living a healthier, active lifestyle. We can’t promise the moon, but it is our responsibility to do the very best we can within our scope, and what we are hired for. If you’re doing that, than you are probably doing it well.


Dawn Baker is an Independent Contractor Personal Trainer, founder of One Accord Fitness LLC and has been changing lives in the fitness industry for 6 years.